A nurse is assessing an adult client who is receiving morphine via continuous IV infusion. The nurse should identify that which of the following is the priority finding?

A) "This medication will not interfere with the effectiveness of oral contraceptives": Rifampin is known to induce hepatic enzymes, which can accelerate the metabolism of oral contraceptives and reduce their effectiveness. Therefore, it is essential for clients taking rifampin to use alternative or additional contraceptive methods to prevent pregnancy.

B) "You can continue to wear soft contact lenses while taking this medication": Rifampin can cause discoloration of bodily fluids, including tears, which may stain soft contact lenses. Therefore, clients taking rifampin should be advised to avoid wearing soft contact lenses during treatment to prevent discoloration and potential eye irritation.

C) "You should take this medication once each day at bedtime": Rifampin is usually taken once daily, but the specific timing may vary depending on the indication and healthcare provider's instructions. While taking rifampin at bedtime may be suitable for some clients, it is important to follow the prescribed dosing schedule provided by the healthcare provider.

D) "Your urine will turn orange while you are taking this medication": Rifampin can cause harmless discoloration of urine, tears, saliva, sweat, and other bodily fluids, turning them orange-red. This side effect is temporary and not harmful. However, informing the client about this potential effect is essential to prevent alarm or unnecessary concern.

A) Morphine 2 mg IV: Morphine is a potent opioid analgesic commonly used to manage moderate to severe pain. However, in this scenario, the client reports pain as 5 on a scale of 0 to 10, which indicates moderate pain. Morphine 2 mg IV may be excessive for this level of pain and could result in unnecessary sedation, respiratory depression, or other opioid-related adverse effects. Therefore, it is not the most appropriate choice for managing the client's pain.

B) Amitriptyline 25 mg PO: Amitriptyline is a tricyclic antidepressant with analgesic properties, but it is not typically used as a first-line treatment for acute postoperative pain. Additionally, it is administered orally and may not provide rapid pain relief in the immediate postoperative period. Therefore, it is not the most suitable option for managing the client's pain after a total knee replacement surgery.

C) Ketorolac 15 mg IV: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that provides potent analgesic and anti-inflammatory effects. It is commonly used for the management of moderate to severe pain, including postoperative pain. In this scenario, the client reports moderate pain after total knee replacement surgery, making ketorolac an appropriate choice for pain management. Administering ketorolac 15 mg IV can provide effective pain relief without the sedative effects of opioids, making it the most suitable PRN medication for the client's pain level.

D) Acetaminophen 650 mg PO: Acetaminophen is a non-opioid analgesic commonly used for mild to moderate pain relief. While acetaminophen is generally safe and effective, it may not provide sufficient pain relief for a client who reports pain as 5 on a scale of 0 to 10 after total knee replacement surgery. Additionally, oral administration may result in delayed onset of action compared to IV medications. Therefore, acetaminophen 650 mg PO may not be the most optimal choice for managing the client's pain in this situation.